Services

NHS 'must be trained to be honest'

NHS staff should be trained in how to be "open and honest" with patients about mistakes in care, a new report has recommended .

A review into proposals to introduce a "duty of candour" in the health service has recommended that staff are taught how to disclose errors.

They should also be trained in how to "apologise where appropriate", according to the Government-commissioned review.

The review, which was led by Royal College of Surgeons president Professor Norman Williams and Salford Royal Hospital chief executive Sir David Dalton, concludes that a statutory duty of candour on NHS providers is an "important step forward".

The move was proposed by Health Secretary Jeremy Hunt in the wake of the Stafford Hospital scandal.

It means that NHS providers would be bound by law to inform patients and their families if an error has been made in their care.

But the review has r ecommended that it is not needed to report a "low" level of harm to patients to avoid "confusion".

Any errors that result in moderate or severe harm or death must be reported, it said.

"Candour is essential for patients and their families," the review states.

"It is the responsibility of professionals, carer organisations and the national bodies that support them to ensure that they have in place, and can sustain, a culture of candour.

"Patients should be well-informed about all elements of care and treatment and all caring staff have a responsibility to be open and honest to those in care."

The report said that "errors will happen" and that care providers must ensure that patients and their families are told "openly and honestly" when mistakes happen "which cause a patient harm above a predetermined threshold".

If a body breaches duty of candour rules, the organisation should face sanctions including: warning notices through to the removal of board members, prosecution, deregistration or a penalty notice from the Care Quality Commission.

Professor Williams said: "When things do go wrong, patients and their families want to be told honestly about what happened, how it might be corrected and to know that it will not happen to someone else.

"Medical care is inherently risky and staff are not infallible. Errors will always be made and clinical staff will always find themselves in the position of having to discuss harm, or potential harm, with a patient.

"A willingness to be open with patients must also include honesty about organisational problems that may have contributed to harm, such as losing notes, problems with discharging patients or poor management of resources. What matters is for organisations to support staff to be honest about those errors, learn from them, apologise when it's the right thing to do and then improve the care and treatment in order to minimise harm in the future.

"We hope that the review will play an important role in helping to create a culture of openness and honesty which always places the safety and needs of a patient above the reputation of an organisation."

Peter Walsh, chief executive of the patient safety charity Action against Medical Accidents, said: "A full duty of candour would probably be the biggest advance in patients' rights and patient safety since the creation of the NHS. For decades the NHS has frowned upon cover-ups but has been prepared to tolerate them. This will be an end to that."

Ministers are expected to publish a response to the review in the next few weeks.

A Department of Health spokeswoman said: "The Francis Inquiry showed us just how important it is that the NHS is open about mistakes so that we can improve care. We welcome this review, and the strong leadership from Sir David Dalton and Professor Norman Williams.

"It is a thorough and well-argued report which deserves careful consideration. We are committed to introducing a statutory duty of candour. We will respond formally to the recommendations shortly."

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